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      Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
    • Numerical inputs and outputsFormula
    • Med treatment and moreTreatment
    • Suggested protocolsAlgorithm

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    Patent Pending

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    EVendo Score for Esophageal Varices

    Predicts presence and size of esophageal varices before screening endoscopy.
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    INSTRUCTIONS

    Use in patients >18 years of age with known or suspected cirrhosis. Do not use in patients with overt GI bleeding or with history of acute variceal hemorrhage.

    When to Use
    Pearls/Pitfalls
    Why Use

    • Patients >18 years of age with known or suspected cirrhosis.

    • Do not use in patients with overt GI bleeding or with history of acute variceal hemorrhage.

    • Noninvasively predicts patients with low probability of any esophageal varices or varices needing treatment (defined as medium to large varices or varices with high-risk features, such as red wale marks) on screening endoscopy.

    • Uses readily available clinical information to calculate.

    • Likely to be less accurate in patients with conditions that, unrelated to severity of liver disease or portal hypertension, could alter the values of the EVendo score inputs (e.g. hemoglobinopathies, Coumadin use, and severe renal dysfunction).

    • Prospectively validated in a cohort of 100 patients.

    Helps identify those who will most benefit from variceal screening and potentially forego the risks and costs of unneeded screening endoscopy at both an individual and public health level.

    U/L
    × 10³/µL
    mg/dL
    g/dL
    Absent
    Present

    Result:

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    Next Steps
    Evidence
    Creator Insights

    Advice

    • Not a substitute for an individual treatment plan developed by a clinician with personal knowledge of a specific patient. As such, it should not be used alone to determine a patient's medical treatment.

    • Screening endoscopy may be deferred when the EVendo score is ≤3.90, and instead patients may be monitored clinically, with reassessment of the EVendo Score at a future date (e.g. in 3-6 months).

    • If access to endoscopy is limited, patients with EVendo scores >3.90 should be prioritized to undergo screening upper endoscopy over patients with lower EVendo scores.

    Content Contributors
    • Alexander Nguyen, MD, PhD
    Reviewed By
    • Jihane Benhammou, MD
    About the Creator
    Dr. James H. Tabibian
    Content Contributors
    • Alexander Nguyen, MD, PhD
    Reviewed By
    • Jihane Benhammou, MD